A motivational interviewing-based counseling intervention to increase postabortion uptake of contraception: A pilot randomized controlled trial

Abstract

Objective: To determine if a counseling intervention using the principles of motivational interviewing (MI) would impact uptake of long-acting reversible contraception (LARC) after abortion.

Methods: We conducted a pilot randomized controlled trial comparing an MI-based contraception counseling intervention to only non-standardized counseling. Sixty women 15-29 years-old were randomized.

Primary outcome: uptake of LARC within four weeks of abortion.

Secondary outcomes: uptake of any effective contraceptive, contraceptive use three months after abortion and satisfaction with counseling. Bivariate analysis was used to compare outcomes.

Results: In the intervention arm, 65.5% of participants received a long-acting method within four weeks compared to 32.3% in the control arm (p=0.01). Three months after the abortion, differences in LARC use endured (60.0% vs. 30.8%, p=0.05). Uptake and use of any effective method were not statistically different. More women in the intervention arm reported satisfaction with their counseling than women in the control arm (92.0% vs. 65.4%, p=0.04).

Conclusion: Twice as many women in the MI-based contraception counseling intervention initiated and continued to use LARC compared to women who received only non-standardized counseling.

Practice implications: A contraception counseling session using the principles and skills of motivational interviewing has the potential to impact LARC use after abortion.

Trial registration: ClinicalTrials.gov NCT01881321.

Keywords: Abortion; Contraception; Counseling; Long acting reversible contraception; Motivational interviewing; Unintended pregnancy.

Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Figures

Figure 1

Trial Flowchart

Figure 2

Method of effective contraception initiated or prescribed immediately or within four weeks after abortion, as determined from the medical record None = no effective method (i.e. no method or barrier method only) DMPA = depot medroxyprogesterone acetate CHC = combined hormonal contraception LARC = long-acting reversible contraception LNG-IUD = levonorgestrel-releasing intrauterine device Cu-IUD = copper intrauterine device